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Lemons-Lyn AB, Baugher AR, Dasgupta S, Fagan JL, Smith SG, Shouse RL. Intimate Partner Violence Experienced by Adults With Diagnosed HIV in the U.S. Am J Prev Med 2021; 60:747-756. [PMID: 33812695 PMCID: PMC8591529 DOI: 10.1016/j.amepre.2020.12.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Intimate partner violence is associated with adverse health consequences among people with diagnosed HIV, which could have implications for disease progression and transmission. However, nationally representative estimates of intimate partner violence among people with diagnosed HIV are lacking. Investigators used nationally representative data to estimate the prevalence of physical violence by an intimate partner among adults with diagnosed HIV and examine the differences by selected characteristics. METHODS This analysis included interview and medical record data from the 2015-2017 cycles of the Medical Monitoring Project, analyzed in 2019. Weighted percentages and 95% CIs were used to report the prevalence of intimate partner violence among people with diagnosed HIV (N=11,768). Bivariate and multivariate differences in intimate partner violence by sociodemographic, behavioral, and clinical characteristics were examined using Rao-Scott chi-square tests (p<0.05). RESULTS Among people with diagnosed HIV, 26.3% reported having ever experienced intimate partner violence, and 4.4% reported having experienced intimate partner violence in the past 12 months. The prevalence of intimate partner violence differed by gender and gender/sexual identity. People who experienced intimate partner violence in the past 12 months were more likely to engage in behaviors associated with elevated HIV transmission risk and have unmet needs for supportive services. People who recently experienced intimate partner violence were less likely to be engaged in routine HIV care but were more likely to seek emergency care services and have poor HIV clinical outcomes. CONCLUSIONS This study's findings support the need for screening people with diagnosed HIV for intimate partner violence and offering linkage to supportive services. Screening for intimate partner violence among people with diagnosed HIV, coupled with supportive services and counseling, may lead to improved safety and HIV clinical outcomes and decreased need for emergency and inpatient medical services.
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Affiliation(s)
- Ansley B Lemons-Lyn
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Amy R Baugher
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sharoda Dasgupta
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer L Fagan
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sharon G Smith
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - R Luke Shouse
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Trauma-Informed Practices to Address Intersections Between HIV and Intimate Partner Violence Among Women: Perspective of Community Service Providers. J Assoc Nurses AIDS Care 2020; 31:176-189. [PMID: 32058333 DOI: 10.1097/jnc.0000000000000163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The current study aimed to document intervention practices, challenges, and training needs concerning the intersections between HIV and intimate partner violence (IPV) among community service providers (n = 12). A direct content analysis using the Trauma-Informed Approach was performed. Results revealed that community service providers need to create a safe, trusting, and mutually collaborative environment in which the intersections between HIV and IPV trauma are recognized, screened, and discussed with women. These results also highlight the need to consolidate partnerships between HIV and IPV organizations to provide relevant services that consider traumatic experiences. Overall, these findings support the urgent need to develop, implement, and evaluate targeted community interventions that jointly address HIV and IPV.
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Abstract
There has been limited study of the syndemic link between HIV and intimate partner violence (IPV) among rural populations in the United States. We utilized the Revised Conflict Tactics Scale-2 to examine the past year prevalence, type (psychological aggression, physical assault, and sexual assault), and the impact of IPV on HIV clinical outcomes among men living with HIV in rural Appalachia. Approximately 39% of participants experienced some type of IPV in the preceding year, with 67% of those individuals experiencing more than 1 type of IPV. Approximately 77% of participants endorsing IPV exposure experienced psychological aggression. Most participants exposed to psychological aggression (70%) and/or physical assault (57%) were both victims and perpetrators, and those experiencing sexual assault reported being exclusively victims (65%). There were no significant differences in clinical outcomes including viral load and CD4 count, which may be secondary to small sample size derived from a clinic population with a high rate of virologic suppression (94%). This study demonstrates the need to assess IPV exposure in men living with HIV and further highlights the intricacies of relationship violence in these individuals.
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Domestic Violence among Pregnant Mothers in Northwest Ethiopia: Prevalence and Associated Factors. ADVANCES IN PUBLIC HEALTH 2017. [DOI: 10.1155/2017/6506231] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. Domestic violence against women is a serious public health concern and human rights violation among pregnant mothers because of its negative effect on the life of both the mother and the fetus. Thus, the aim of this study was to assess the prevalence of domestic violence and associated factors among pregnant women. Methods. An institution based quantitative cross-sectional study was conducted among 418 women using a systematic random sampling technique. Binary logistic regression analysis and adjusted odds ratio with 95% confidence interval were used to identify the associated factors. Results. Overall, the prevalence of domestic violence was found to be 25.4%. Of this, the prevalence of psychological, physical, and sexual violence was 24.5%, 8.1%, and 2.4%, respectively. Low educational status (AOR = 4.59, CI: 1.496, 14.070), rural residency (AOR = 5.53, CI: 2.311, 13.249), unplanned pregnancy (AOR = 4.34, CI: 2.345, 8.020), and late initiation of antenatal care (AOR = 5.41, CI: 1.493, 19.696) were factors associated with domestic violence at p value < 0.05. Conclusion. Overall, more than quarter of the study participants had experienced domestic violence. Lower educational status, rural residency, unplanned pregnancy, and late initiation of antenatal care were factors associated with domestic violence. Thus, the authors suggest strengthening provision of women’s reproductive health information.
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Johnson DM, Johnson NL, Beckwith CG, Palmieri PA, Zlotnick C. Rapid Human Immunodeficiency Virus Testing and Risk Prevention in Residents of Battered Women's Shelters. Womens Health Issues 2017; 27:36-42. [PMID: 27914861 PMCID: PMC5177527 DOI: 10.1016/j.whi.2016.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 10/21/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection and intimate partner violence (IPV) are interconnected public health problems. However, few HIV prevention interventions address the unique needs of IPV survivors in shelter and none of the Centers for Disease Control and Prevention's best-evidence risk reduction interventions adequately explore the complex relationship between IPV and HIV risk. Although battered women's shelters provide a safe and supportive environment for women in crisis, most do not offer HIV risk reduction services or sexual safety planning. METHODS This study evaluated the feasibility, acceptability, and initial efficacy of rapid HIV testing and brief risk prevention intervention developed for residents of battered women's shelters. The Safe Alternatives For Empowered sex for intimate partner violence intervention (SAFE-IPV) was evaluated in an open trial (N = 98). Participants were assessed with a series of standardized interviews and self-reports at screening and 3 months after leaving the shelter. RESULTS Few eligible participants declined SAFE-IPV and participants who received SAFE-IPV reported high levels of satisfaction. No participants in the open trial tested positive for HIV. However, participants reported significantly fewer unprotected vaginal and anal sexual occasions and increased intentions to engage in risk preventative behaviors 3 months after leaving shelter compared with the 3 months before shelter. Additionally, participants reported significant improvements on HIV risk factors addressed in SAFE-IPV at the 3-month follow-up (i.e., reduced emotional, physical, and sexual harm by abuser, posttraumatic stress symptoms, hazardous alcohol use, and drug use). DISCUSSION These results extend prior research on HIV prevention with women with IPV, demonstrating the acceptability, feasibility, and initial efficacy of SAFE-IPV within battered women's shelter settings.
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Affiliation(s)
- Dawn M Johnson
- Department of Psychology, University of Akron, Akron, Ohio.
| | | | - Curt G Beckwith
- Department of Medicine, Division of Infectious Diseases, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Patrick A Palmieri
- Summa Health System, Department of Psychiatry, Center for the Treatment and Study of Traumatic Stress, Akron, Ohio
| | - Caron Zlotnick
- Department of Psychiatry, Butler Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Rojas P, Huang H, Li T, Ravelo GJ, Sanchez M, Dawson C, Brook J, Kanamori M, De La Rosa M. Sociocultural Determinants of Risky Sexual Behaviors among Adult Latinas: A Longitudinal Study of a Community-Based Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1164. [PMID: 27886095 PMCID: PMC5129374 DOI: 10.3390/ijerph13111164] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/11/2016] [Accepted: 11/15/2016] [Indexed: 11/29/2022]
Abstract
Few studies have examined the sociocultural determinants of risky sexual behavior trajectories among adult Latinas. To longitudinally examine the link between sociocultural determinants of risky sexual behaviors, we followed a sample of adult Latina mother-daughter dyads (n = 267) across a 10-year span through four waves of data collection. The present study investigates how risky sexual behavior (operationalized as sex under the influence of alcohol or other drugs, sex without a condom, or multiple sex partners) is affected by: (a) socioeconomic conditions; (b) mental health; (c) medical health; (d) acculturation to U.S. culture; (e) interpersonal support; (f) relationship stress; (g) mother-daughter attachment; (h) intimate partner violence; (i) religious involvement; and (j) criminal justice involvement. Results indicate the following factors are negatively associated with risky sexual behavior: drug and alcohol use, treating a physical problem with prescription drugs, religious involvement, and mother-daughter attachment. The following factors are positively associated with risky sexual behavior: higher number of mental health symptoms, being U.S.-born, and criminal justice involvement. We discuss implications for the future development of culturally relevant interventions based on the study findings.
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Affiliation(s)
- Patria Rojas
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Hui Huang
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Tan Li
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- Department of Biostatistics, School of Public Health, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Gira J Ravelo
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Mariana Sanchez
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Christyl Dawson
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Judith Brook
- New York University School of Medicine, New York University, 215 Lexington Avenue, New York, NY 10017, USA.
| | - Mariano Kanamori
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, FL 33199, USA.
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL 33199, USA.
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Seth P, Figueroa A, Wang G. Centers for Disease Control and Prevention-Funded Human Immunodeficiency Virus Testing, Positivity, and Service Delivery among Newly Diagnosed Women in 61 Health Department Jurisdictions, United States, 2014. Womens Health Issues 2016; 26:496-503. [PMID: 27424776 DOI: 10.1016/j.whi.2016.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 05/27/2016] [Accepted: 05/31/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND More than 1.2 million persons are living with human immunodeficiency virus (HIV) in the United States; at the end of 2011, 23% of them were women. Minority women are disproportionately affected by HIV, and new infections are higher among older women. HIV testing and service delivery among women funded by the U.S. Centers for Disease Control and Prevention (CDC) is examined. METHODS Data were submitted by 61 health department jurisdictions. HIV testing, HIV-positive tests, new HIV diagnoses among women, and linkage and referral services among newly diagnosed women are described. Differences across demographic characteristics for HIV diagnoses, linkage, and referral services were assessed. Diagnoses were identified as new when women who tested HIV positive were not found to be reported previously in the jurisdiction's HIV surveillance system; when jurisdictions could not verify prior test results in their surveillance systems, new diagnoses were identified by self-report. RESULTS Of CDC-funded testing events in 2014, 1,484,902 (48.7%) were among women, and they accounted for 19.5% of all HIV-positive testing events. Among women tested, 0.4% were HIV positive, and 0.1% had new HIV diagnoses. Women aged 40 and older and Black women were more likely to test HIV positive (0.7% and 0.5%, respectively). Among newly diagnosed women, 62.8% were linked within any timeframe, 57.1% were linked within 90 days, 74.1% were referred to partner services, 57.5% were interviewed for partner services, and 55.5% were referred to HIV risk reduction services. CONCLUSIONS Among all women receiving CDC-funded HIV testing, Black women and older women were more likely to have HIV-positive tests and new diagnoses. Although women overall may not be at the highest risk for HIV, Black women in this sample are disproportionately affected. Additionally, linkage, referral, and interview services for women need improvement. Targeted testing approaches may ensure effective test-and-treat strategies for women.
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Affiliation(s)
- Puja Seth
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Argelia Figueroa
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Guoshen Wang
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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